A new study published in the Journal of the American Heart Association this month reveals that pregnant women have a significantly high risk of developing a stroke. According to the lead author of the study, Dr. Elena V. Kuklina (senior service fellow and epidemiologist at the Center for Disease Control and Prevention (CDC)), “the overall rate of women having strokes while they are expecting a baby and in the three months after birth went up 54% in the 12 years leading up to 2006-07.”
This is a significant finding! To put it in context, consider the following facts about stroke:
- Stroke is the third leading cause of death in the United States. Over 143,579 people die each year from stroke in the United States.
- Stroke is the leading cause of serious, long-term disability in the United States.
- Each year, about 795,000 people suffer a stroke. About 600,000 of these are first attacks, and 185,000 are recurrent attacks.
- Nearly three-quarters of all strokes occur in people over the age of 65. The risk of having a stroke more than doubles each decade after the age of 55.
- Strokes can – and do – occur at ANY age. Nearly one quarter of strokes occur in people under the age of 65.
- Stroke death rates are higher for African Americans than for whites, even at younger ages.
- Among adults age 20 and older, the prevalence of stroke in 2005 was 6,500,000 (about 2,600,000 males and 3,900,000 females).
- On average, every 40 seconds someone in the United States has a stroke.
- Each year, about 55,000 more women than men have a stroke.
“A stroke is an interruption of the blood supply to any part of the brain. A stroke is sometimes called a ‘brain attack.’” The following are well-recognized stroke risk factors: high blood pressures (hypertension), atrial fibrillation, diabetes, heart disease, high cholesterol, increasing age, and a family history of strokes. Being pregnant is a risk factor in and of itself.
As part of the study, Dr. Kuklina and colleagues used information from 5 to 8 million discharge records from about 1000 hospitals. According to Dr. Kuklina, the increase in the stroke rate during pregnancy and in the 3 months after birth was mainly attributable to high blood pressure and obesity. The study enumerates these specific findings:
- Pregnancy-related stroke hospitalizations went up by 54%, from 4,085 to 6,293 over the 12 years leading up to 2006- 07.
- Strokes in pregnancy went up by 47% (from 0.15 to 0.22 per 1,000 deliveries).
- Strokes recently after giving birth went up by 83% (from 0.12 to 0.22 per 1,000 deliveries).
- Strokes during delivery did not change (they stayed at 0.27 per 1,000 deliveries).
- In 2006-07, about 32% and 53% of women who were hospitalized after having strokes in pregnancy and shortly after giving birth respectively had either high blood pressure or heart disease.
- Increased prevalence of these two conditions over the 12 years up to 2006-07 accounted for almost all the increase in stroke hospitalization after giving birth that occurred in the same period.
It appears that an increasingly larger number of women enter pregnancy with one or more stroke risk factors. This is particularly true with respect to hypertension and obesity. According to Dr. Kuklina, “[s]ince pregnancy by itself is a risk factor, if you have one of these other stroke risk factors, it doubles the risk.” For this reason, it is particularly important to enter pregnancy in relatively good cardiovascular health and to reduce other risk factors, if possible. If you are pregnant or plan on becoming pregnant, talk to your OB/GYN about your stroke risk factors. In collaboration with your physician, implement a plan to manage and reduce your stroke risks before, during, and after pregnancy.
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